QUESTION: What is the effectiveness and what are the adverse effects. DESIGN: Systematic review with meta-analysis. PARTICIPANTS: Patients with shoulder or upper extremity pain or dysfunction. INTERVENTION: Trigger point dry needling (TDN) compared to control, another intervention or another needling technique. OUTCOME MEASURES: Primary outcome measures included shoulder or upper limb pain, shoulder or upper limb dysfunction...

Ankylosing spondylitis (AS) is a type of arthritis that is referred to a group of chronic immune-mediated inflammatory diseases termed as seronegative spondyloarthropathies or spondyloarthritides. It typically affects the joints of the spinal and axial skeleton and exhibits common clinical features and genetic factors such as human leukocyte antigen class I allele HLA-B27, the Endoplasmic Reticulum Aminopeptidase 1 (ERAP1), and environmental factors such as microbial triggers. Although the precise etiopathogenic mechanisms that implicate the pathogenesis of AS have still remained to be clarified, the IL-23/IL-17 immune axis has been detected as an important factor in the immunopathogenesis of AS...

Many different diseases are associated with fibrosis of the skin. The clinical symptoms can vary considerably with a broad range from isolated small areas to the involvement of the entire integument. Fibrosis is triggered by a multitude of different stimuli leading to activation of the immune and vascular system that then initiate fibroblast activation and formation of matrix depositing and remodeling myofibroblasts. Ultimately, myofibroblasts deposit excessive amounts of extracellular matrix with a pathological architecture and alterations in growth factor binding and biomechanical properties, which culminates in skin hardening and loss of mobility...

BACKGROUND: As the potential for cancer therapy-related cardiac dysfunction is increasingly recognized, there is a need for the standardization of echocardiographic measurements and cut points to guide treatment. The aim of this study was to determine the reproducibility of cardiac safety assessments across two academic echocardiography core laboratories (ECLs) at the University of Pennsylvania and the Duke Clinical Research Institute. METHODS: To harmonize the application of guideline-recommended measurement conventions, the ECLs conducted multiple training sessions to align measurement practices for traditional and emerging assessments of left ventricular (LV) function...

Much of the recent excitement in the cancer immunotherapy approach has been generated by the recognition that immune checkpoint proteins, like the receptor PD-1, can be blocked by antibody-based drugs with profound effects. Promising clinical data have already been released pointing to the efficiency of the drug pembrolizumab to block the PD-1 pathway, triggering the T-lymphocytes to destroy the cancer cells. Thus, a deep understanding of this drug/receptor complex is essential for the improvement of new drugs targeting the protein PD-1...

The incidence of malignant melanoma has continued to rise during the past decades. However, in the last few years, treatment protocols have significantly been improved thanks to a better understanding of the key oncogenes and signaling pathways involved in its pathogenesis and progression. Anticancer therapy would either kill tumor cells by triggering apoptosis or permanently arrest them in the G1 phase of the cell cycle. Unfortunately, melanoma is often refractory to commonly used anticancer drugs. More recently, however, some new anticancer strategies have been developed that are "external" to cancer cells, for example stimulating the immune system's response or inhibiting angiogenesis...

Invasive fungal infections are associated with high mortality rates, despite appropriate antifungal therapy. Limited therapeutic options, resistance development and the high mortality of invasive fungal infections brought about more concern triggering the search for new compounds capable of interfering with fungal viability and virulence. In this context, peptides gained attention as promising candidates for the antimycotics development. Variety of structural and functional characteristics identified for various natural antifungal peptides makes them excellent starting points for design novel drug candidates...

CONTEXT: Chronic musculoskeletal disorders in shoulder joint are often associated with myofascial trigger points (MTrP), particularly in the upper trapezius (UT) muscle. Dry needling (DN) is a treatment of choice for myofascial pain syndrome. However, local lesions and severe post-needle soreness sometimes hamper the direct application of DN in the UT. Therefore, finding an alternative point of treatment seems useful in this regard. OBJECTIVE: To compare the efficacy of UT versus infraspinatus (ISP) DN on pain and disability of subjects with shoulder pain...

CONTEXT: Collegiate soccer players suffer hamstring injuries due to inflexibility and repetitive motions involving intense hamstring lengthening and contraction during sport. Although a popular intervention for muscular injury, there exists limited evidence of the effects of therapeutic cupping on hamstring flexibility. OBJECTIVE: To determine the effect of cupping therapy on hamstring flexibility in collegiate soccer players. DESIGN: Cohort design...

PURPOSE: Modern cardiac implantable devices provide diagnostic information on several physiological variables which are associated with worsening heart failure, creating an opportunity for early intervention to prevent heart failure symptoms and hospitalizations. We evaluated diagnostic accuracy and workload of a remote monitoring (RM) workflow algorithm which leverages intrathoracic impedance and other device diagnostics. METHODS: In our RM workflow a team of expert nurses was responsible for continuity of care, direct relationship with patients and implementation of a specific protocol to evaluate RM alerts and to limit unnecessary resource consumption...

BACKGROUND: Previous studies in patients with limb-girdle muscular dystrophy type 2A (LGMD2A) have suggested that calpain-3 (CAPN3) mutations result in aberrant regeneration in muscle. METHODS: To gain insight into pathogenesis of aberrant muscle regeneration in LGMD2A, we used a paradigm of cardiotoxin (CTX)-induced cycles of muscle necrosis and regeneration in the CAPN3-KO mice to simulate the early features of the dystrophic process in LGMD2A. The temporal evolution of the regeneration process was followed by assessing the oxidative state, size, and the number of metabolic fiber types at 4 and 12 weeks after last CTX injection...

In recent years, acupuncture has been applied to treat more and more patients suffering from polycystic ovary syndrome (PCOS). On June 27, 2017 a paper titled "Effect of acupuncture and clomiphene in Chinese women with polycystic ovary syndrome: a randomized clinical trial" was published in Journal of the American Medical Association (JAMA). The results did not support acupuncture as an effective therapy for improving the live births in PCOS. The aim of this article was to analyze the therapeutic regimen and design of the clinical trial...

OBJECTIVE: To compare the clinical efficacy on primary trigeminal neuralgia between the combined therapy of electroacupuncture and triple puncture and the routine electroacupuncture therapy. METHODS: Thirty-six patients of primary trigeminal neuralgia were randomly assigned into an electroacupuncture and triple puncture group (group A) and a routine electroacupuncture group (group B), 18 cases in each one. In the group A, the triple puncture technique was used at the trigger points (the positive reactive points to trigger facial pain) and stimulated with electricity...

: The study presents a model of shear-stress-based platelet activation. Twenty-eight patients (22 free from anticoagulants and major antiplatelet agents, and six under the effects of P2Y12 platelet inhibitors) participated. The main purpose was to verify the hypothesis that a model of shear-dependent blood activation does not require artificial activators to trigger clot formation. Whole blood collected from the patients received platelet function tests [ADPtest and thrombin receptor-activating peptide (TRAP)test] and was tested with a cone-on-plate viscosimeter at a shear rate of 100 s...

OBJECTIVE: The aim of the study was to prove the causality between the craniocervical dysfunction and myofascial pain in the head and neck and to demonstrate the clinical value and usefulness of physiotherapy as one of the therapeutic options for myofascial pain. METHODS: The group of patients diagnosed with myofascial dysfunctional pain syndrome contained 98 patients out of which 79 patients (81 %) were females and 19 patients (19 %) were males. The majority of the patients were aged between 26 and 35 years; the total age range was 14-77 years with the average of 38 years...

Current evidence suggests positive effects of exercise on posttraumatic stress symptoms; however, knowledge about how these effects are achieved is limited. Thus, this study aims to contribute to a more holistic understanding of these effects. We performed a single case study of a war and torture survivor, who was diagnosed with posttraumatic stress disorder (PTSD) and depression, and who was participant of the sport and exercise therapy program Movi Kune. Participant observation was conducted as well as semi-structured interviews with the participant and his psychotherapist...

The primary aim in tissue engineering is to repair, replace, and regenerate dysfunctional tissues to restore homeostasis. Cell delivery for repair and regeneration is gaining impetus with our understanding of constructing tissue-like environments. However, the perpetual challenge is to identify innovative materials or re-engineer natural materials to model cell-specific tissue-like 3D modules, which can seamlessly integrate and restore functions of the target organ. To devise an optimal functional microenvironment, it is essential to define how simple is complex enough to trigger tissue regeneration or restore cellular function...